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Abstract

Background and Objective

Tourette Syndrome (TS) typically appears in childhood. The adverse childhood experiences of individuals with TS may influence their adult well-being. The social adjustment problems of adults with TS are often ignored in clinical practice. This study explored how Chinese adults with TS in Taiwan, Hong Kong, and Mainland China understand and are affected by TS.

Methods

We recruited 19 individuals with moderate-to-severe TS from ad hoc TS support groups in Taiwan, Hong Kong, and Mainland China and conducted semi-structured in-depth interviews between April 2015 and January 2016, and between June and September 2022. A total of 9 participants completed three quantitative scales: Gilles de la Tourette syndrome - quality of life scale (GTS-QoL) and two self-assessments, namely the severity of TS symptom index (S-TS-I) and satisfaction with life index (SL-I).

Results

We identified ten resilience factors, which were categorized into two main categories. The first category, “Mental Health with Social Challenges” included lack of family support, struggles to adapt to social expectations of normal behavior, bullying from peers, friends, or teachers, and negative thoughts about TS. The second category, “Support Systems and Coping Mechanisms,” encompassed support from families, support from teachers and friends, positive thoughts about TS, professional guidance, life goals, and coping strategies. We found that adults with TS who had more “Support Systems with Coping Mechanisms” than “Mental Health with Social Challenges” were more satisfied with their lives. Surprisingly, GTS-QoL was correlated with S-TS-I (TS severity) but not with SL-I scores (TS satisfaction). The participants exhibited differences in cultural beliefs and perceptions of TS depending on the locale.

Conclusions

Two prominent categories were identified pertaining to how Chinese people with TS understand, are affected by, and cope with their condition.

© 2025 The Author(s).
© 2025 The Author(s). Published by Bentham Science Publishers. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2025-04-09
2025-10-05

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References

  1. Cox J.H. Nahar A. Termine C. Agosti M. Balottin U. Seri S. Cavanna A.E. Social stigma and self-perception in adolescents with tourette syndrome. Adolesc. Health Med. Ther. 2019 10 75 82 10.2147/AHMT.S175765 31354374
    [Google Scholar]
  2. Charania S.N. Danielson M.L. Claussen A.H. Lebrun-Harris L.A. Kaminski J.W. Bitsko R.H. Bullying victimization and perpetration among US children with and without tourette syndrome. J. Dev. Behav. Pediatr. 2022 43 1 23 31 10.1097/DBP.0000000000000975 34050089
    [Google Scholar]
  3. Eapen V. Cavanna A.E. Robertson M.M. Comorbidities, social impact, and quality of life in tourette syndrome. Front. Psychiatry 2016 7 97 10.3389/fpsyt.2016.00097 27375503
    [Google Scholar]
  4. Knight T. Steeves T. Day L. Lowerison M. Jette N. Pringsheim T. Prevalence of tic disorders: A systematic review and meta-analysis. Pediatr. Neurol. 2012 47 2 77 90 10.1016/j.pediatrneurol.2012.05.002 22759682
    [Google Scholar]
  5. Set K.K. Warner J.N. Tourette syndrome in children: An update. Curr. Probl. Pediatr. Adolesc. Health Care 2021 51 7 101032 34305006
    [Google Scholar]
  6. Wang H.S. Kuo M.F. Tourette’s syndrome in Taiwan: An epidemiological study of tic disorders in an elementary school at Taipei County. Brain Dev. 2003 25 Suppl. 1 S29 S31 10.1016/S0387‑7604(03)90005‑2 14980369
    [Google Scholar]
  7. Wong C.K. Lau J.T.F. Psychiatric morbidity in a Chinese primary school in Hong Kong. Aust. N. Z. J. Psychiatry 1992 26 3 459 466 10.3109/00048679209072071 1417633
    [Google Scholar]
  8. Yang C. Zhang L. Zhu P. Zhu C. Guo Q. The prevalence of tic disorders for children in China. Medicine 2016 95 30 e4354 10.1097/MD.0000000000004354 27472724
    [Google Scholar]
  9. Baizabal-Carvallo J.F. Jankovic J. Sex differences in patients with Tourette syndrome. CNS Spectr. 2022 28 2 1 7 35170423
    [Google Scholar]
  10. Chou I.J. Hung P.C. Lin J.J. Hsieh M.Y. Wang Y.S. Kuo C.Y. Kuo C.F. Lin K.L. Wang H.S. Incidence and prevalence of Tourette syndrome and chronic tic disorders in Taiwan: A nationwide population-based study. Soc. Psychiatry Psychiatr. Epidemiol. 2022 57 8 1711 1721 10.1007/s00127‑022‑02253‑7 35467133
    [Google Scholar]
  11. Yan J. Deng H. Wang Y. Wang X. Fan T. Li S. Wen F. Yu L. Wang F. Liu J. Wu Y. Zheng Y. Cui Y. Li Y. The prevalence and comorbidity of tic disorders and obsessive-compulsive disorder in chinese school students aged 6–16: A national survey. Brain Sci. 2022 12 5 650 10.3390/brainsci12050650 35625036
    [Google Scholar]
  12. Hirschtritt M.E. Lee P.C. Pauls D.L. Dion Y. Grados M.A. Illmann C. King R.A. Sandor P. McMahon W.M. Lyon G.J. Cath D.C. Kurlan R. Robertson M.M. Osiecki L. Scharf J.M. Mathews C.A. Tourette Syndrome Association International Consortium for Genetics Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015 72 4 325 333 10.1001/jamapsychiatry.2014.2650 25671412
    [Google Scholar]
  13. Yau E. Tourette’s in China: how a sufferer’s video helps public understanding and acceptance. 2018 Available from: https://www.scmp.com/lifestyle/health-wellness/article/2152590/tourettes-china-how-sufferers-video-helps-public
  14. Leisman G. Sheldon D. Tics and emotions. Brain Sci. 2022 12 2 242 10.3390/brainsci12020242 35204005
    [Google Scholar]
  15. Park S. Lee Y. Kim C.E. Korean adults’ beliefs about and social distance toward attention-deficit hyperactivity disorder, Tourette syndrome, and autism spectrum disorder. Psychiatry Res. 2018 269 633 639 10.1016/j.psychres.2018.08.023 30212793
    [Google Scholar]
  16. Pluye P. Hong Q.N. Combining the power of stories and the power of numbers: Mixed methods research and mixed studies reviews. Annu. Rev. Public Health 2014 35 1 29 45 10.1146/annurev‑publhealth‑032013‑182440 24188053
    [Google Scholar]
  17. Borg S. Gerdtham U.G. Eeg-Olofsson K. Palaszewski B. Gudbjörnsdottir S. Quality of life in chronic conditions using patient-reported measures and biomarkers: A DEA analysis in type 1 diabetes. Health Econ. Rev. 2019 9 1 31 10.1186/s13561‑019‑0248‑4 31696324
    [Google Scholar]
  18. Tseng P. The narrative research of adversity experiences of people with Tourette syndrome 2017
    [Google Scholar]
  19. Cavanna A.E. Schrag A. Morley D. Orth M. Robertson M.M. Joyce E. Critchley H.D. Selai C. The Gilles de la Tourette syndrome-quality of life scale (GTS-QOL): Development and validation. Neurology 2008 71 18 1410 1416 10.1212/01.wnl.0000327890.02893.61 18955683
    [Google Scholar]
  20. Solís-García G. Jové-Blanco A. Chacón-Pascual A. Vázquez-López M. Castro-De Castro P. Carballo J.J. Pina-Camacho L. Miranda-Herrero M.C. Quality of life and psychiatric comorbidities in pediatric patients with Gilles de la Tourette syndrome. Rev. Neurol. 2021 73 10 339 344 34755886
    [Google Scholar]
  21. Maercker A. Ben-Ezra M. Esparza O.A. Augsburger M. Fatalism as a traditional cultural belief potentially relevant to trauma sequelae: Measurement equivalence, extent and associations in six countries. Eur. J. Psychotraumatol. 2019 10 1 1657371 10.1080/20008198.2019.1657371 31528270
    [Google Scholar]
  22. Matel-Anderson D.M. Bekhet A.K. Garnier-Villarreal M. Mediating effects of positive thinking and social support on suicide resilience. West. J. Nurs. Res. 2019 41 1 25 41 10.1177/0193945918757988 29460692
    [Google Scholar]
  23. Mesman E. Vreeker A. Hillegers M. Resilience and mental health in children and adolescents: An update of the recent literature and future directions. Curr. Opin. Psychiatry 2021 34 6 586 592 10.1097/YCO.0000000000000741 34433193
    [Google Scholar]
  24. Chen Y. Chinese values, health and nursing. J. Adv. Nurs. 2001 36 2 270 273 10.1046/j.1365‑2648.2001.01968.x 11580802
    [Google Scholar]
  25. Hsiao F.H. Klimidis S. Minas H. Tan E.S. Cultural attribution of mental health suffering in Chinese societies: The views of Chinese patients with mental illness and their caregivers. J. Clin. Nurs. 2006 15 8 998 1006 10.1111/j.1365‑2702.2006.01331.x 16879544
    [Google Scholar]
  26. Lee M.Y. Wang H.S. Chen C.J. Lee M.H. Social adjustment experiences of adolescents with Tourette syndrome. J. Clin. Nurs. 2019 28 1-2 279 288 10.1111/jocn.14564 29893437
    [Google Scholar]
  27. Chen S.X. Mak W.W.S. Lam B.C.P. Is it cultural context or cultural value? Unpackaging cultural influences on stigma toward mental illness and barrier to help-seeking. Soc. Psychol. Personal. Sci. 2020 11 7 1022 1031 10.1177/1948550619897482
    [Google Scholar]
  28. Mak W.W.S. Chen S.X. Illness behaviors among the Chinese. Cross-Cultural Psychology, The Oxford handbook of Chinese psychology Oxford University Press 2010 421 439 10.1093/oxfordhb/9780199541850.013.0026
    [Google Scholar]
  29. Heiniger L.E. Sherman K.A. Shaw L.K.E. Costa D. Fatalism and health promoting behaviors in Chinese and Korean immigrants and Caucasians. J. Immigr. Minor. Health 2015 17 1 165 171 10.1007/s10903‑013‑9922‑5 24072515
    [Google Scholar]
  30. Nussey C. Pistrang N. Murphy T. Does it help to talk about tics? An evaluation of a classroom presentation about Tourette syndrome. Child Adolesc. Ment. Health 2014 19 1 31 38 10.1111/camh.12000 32878362
    [Google Scholar]
  31. Feng D. Su S. Wang L. Liu F. The protective role of self-esteem, perceived social support and job satisfaction against psychological distress among Chinese nurses. J. Nurs. Manag. 2018 26 4 366 372 10.1111/jonm.12523 29624766
    [Google Scholar]
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“Mental Health with Social Challenges” and “Support Systems with Coping Mechanisms” Among Chinese Adults with Tourette Syndrome in three Locales: A Qualitative Study
Bentham Science Publishers ; https://doi.org/10.2174/0126660822332433250402071542
/content/journals/cprr/10.2174/0126660822332433250402071542
/content/journals/cprr/10.2174/0126660822332433250402071542
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  • Article Type:     Research Article
Keywords: Tourette syndrome ; Chinese ; qualitative interview ; resilience ; adverse experience

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